Oesophageal atresia and tracheo-oesophageal fistulaOverview

Oesophageal atresia is a rare birth defect that affects a baby's oesophagus (the tube through which food passes from the mouth to the stomach).

The upper part of the oesophagus doesn't connect with the lower oesophagus and stomach. It usually ends in a pouch, which means food can't reach the stomach.

It often happens along with another birth defect called a tracheo-oesophageal fistula, which is a connection between the lower part of the oesophagus and the windpipe (trachea).

This causes air to pass from the windpipe to the oesophagus and stomach, and stomach acid to pass into the lungs.

These defects mean the baby won't be able to swallow safely, if at all.

They could also develop life-threatening problems such as choking and pneumonia if not treated quickly, so surgery will usually be carried out within a few days of birth.

Causes of oesophageal atresia

Oesophageal atresia is thought to be caused by a problem with the development of the oesophagus while the baby is in the womb, although it's not clear exactly why this happens.

The condition is more common in babies of mothers who had too much amniotic fluid in pregnancy (polyhydramnios).

It's also more common in babies who have problems with the development of their kidneys, heart and spine.

The risk of having another baby with oesophageal atresia is thought to be very small.

Diagnosing oesophageal atresia

Doctors may suspect your baby has oesophageal atresia before they're born if routine ultrasound scans show a lot of amniotic fluid in the womb, although this can have a number of causes.

Tests to check for the condition will be carried out after your baby is born, if they seem to be having problems swallowing or breathing.

A thin feeding tube may be passed down your baby's throat through their nose, to see if it reaches their stomach, and an X-ray may be carried out to check the oesophagus.

Repairing the defects

An operation to repair an oesophageal atresia and tracheo-oesophageal fistula is usually done soon after birth.

Your baby will be taken to the neonatal intensive care unit, where they're given a general anaesthetic.

They will receive nutrition into a vein (intravenously) and a suction tube is used to remove fluid from the pouch in their oesophagus.

The surgeon makes a cut on the right side of the chest, between the ribs, and closes off the abnormal connection (fistula) between the oesophagus and windpipe. The surgeon will then sew together the upper and lower parts of the oesophagus.

If the gap in the oesophagus is large, your child may need to wait a few months for the operation, to allow their oesophagus to grow a bit more.

In this case, they'll need to have a feeding tube temporarily placed into their stomach through their tummy. Occasionally, a procedure to lengthen the oesophagus before repairing it may be carried out.

After surgery

After surgery, your child will be kept in the intensive care unit and placed in an incubator.